How to reimburse the money with maternity insurance

Maternity insurance** compensates the employer in the form of maternity allowance. Maternity allowance = 30 (days) of the average salary paid by the unit in the current month. Maternity Medical Expenses:

The medical expenses for medical treatment after confirming the status of maternity medical treatment shall be settled by the Municipal Labor and Social Security Bureau and the hospital in a fixed amount. Other types of subsidies and different situations shall be implemented in accordance with relevant regulations.

Maternity insurance cannot be reimbursed after it has been discontinued.

Maternity insurance payment.

Maternity insurance is a social policy for the protection of the rights and interests of female employees in national legislation, and regardless of whether the fetus is born normally, even if the fetus dies and has a miscarriage, etc., you can enjoy maternity insurance.

Before enjoying the maternity allowance, the unit needs to apply for maternity insurance for you, and needs to prepare three forms, the basic pension, work-related injury and maternity insurance declaration summary table for enterprise employees, the social security registration form, and the increase and decrease table of pension, work and maternity insurance personnel, and the three forms are prepared by the enterprise;

The unit shall go to the social labor insurance department with these three forms to declare, and after the labor insurance department accepts the application, it will return two stamped forms;

Wait until the next month, the unit can normally pay the maternity insurance premiums of the new employees, which must be paid by the tax department;

After giving birth, a female employee submits materials to the social labor insurance department for insurance payment before the maternity leave reaches 30 days (pay attention to the time, it is more troublesome to handle it overdue);

The materials for insurance payment mainly include: the birth status form of employees of urban enterprises, identity information, birth certificates, medical certificates from hospitals, and medical settlement lists.

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The reimbursement process for maternity insurance benefits is as follows:

Application materials to be submitted by the employer:

1. Social insurance registration form;

2. The increase and decrease table of personnel participating in basic old-age, work-related injury and maternity insurance;

3. Summary table of basic pension, work-related injury and maternity insurance declaration for enterprise employees.

Application materials to be submitted:

1. Family planning certificate issued by the family planning department (original and photocopy);

2. Birth (death) certificate of the baby issued by the medical department (original and photocopy);

3. ID card of female employees who give birth and employees of family planning surgery (original and photocopy);

4. Examination and collection form of maternity medical certificate for enterprise employees;

5. Application form for medical certificate of family planning surgery for employees of enterprises;

6. Application form for reimbursement of maternity medical expenses for enterprise employees;

7. Approval and settlement of maternity insurance benefits for enterprise employees;

8. Application form for foreign medical treatment of maternity insurance for enterprise employees;

9. Original materials such as maternity medical expense bills, expense lists, outpatient medical records, and discharge summaries;

Application materials to be submitted by the employer:

1. Social insurance registration form;

2. The increase and decrease table of personnel participating in basic old-age, work-related injury and maternity insurance;

3. Summary table of basic pension, work-related injury and maternity insurance declaration for enterprise employees.

Application materials to be submitted by female employees who give birth:

1. Family planning certificate issued by the family planning department (original and photocopy);

2. Birth (death) certificate of the baby issued by the medical department (original and photocopy);

3. ID card of female employees who give birth and employees of family planning surgery (original and photocopy);

4. Examination and collection form of maternity medical certificate for enterprise employees;

5. Application form for medical certificate of family planning surgery for employees of enterprises;

6. Application form for reimbursement of maternity medical expenses for enterprise employees;

7. Approval and settlement of maternity insurance benefits for enterprise employees;

8. Application form for foreign medical treatment of maternity insurance for enterprise employees;

9. Original materials such as maternity medical expense bills, expense lists, outpatient medical records, and discharge summaries;

10. Receipt of payment.

Documents to be submitted by a male employee whose spouse gives birth:

1. Family planning certificate issued by the family planning department (original and photocopy);

2. Birth (death) certificate of the baby issued by the medical department (original and photocopy);

3. ID card of the male employee (original and copy);

Maternity medical expenses shall be applied for before the female employee becomes pregnant and gives birth or terminates the pregnancy;

Maternity allowances, one-time nutrition subsidies for childbirth, and maternity medical expenses for medical treatment in other places shall be applied for within one year after the female employee gives birth or terminates pregnancy;

The cost of family planning surgery shall be applied for before the operation;

Leave allowance for male employees shall be applied for within one year after the birth of their spouse.

If the application is overdue, the social insurance agency will not accept it.

If the employer fails to apply for maternity insurance benefits for its insured employees at the local social insurance agency within the prescribed time limit, the maternity insurance benefits of the employees shall be paid by the employer in accordance with the treatment items and standards of the overall planning area.

The maternity insurance system refers to a social insurance system in which the employer pays the insurance premiums and its employees or their unemployed spouses enjoy maternity insurance benefits in accordance with the provisions of the state. It should be reminded that maternity insurance is a typical local policy, some places need to pay for more than 10 months, while some places need to pay for more than one year, but in either case, you need to continue to pay maternity insurance when you want to be reimbursed.

For maternity insurance benefits, in fact, when you need a diagnosis in the hospital, the doctor will also give corresponding instructions, and you can also keep your receipt to the Social Security Bureau for insurance.

How can maternity insurance benefits be reimbursed? When you have a baby, or have a ring removed, removed or had an abortion, you can get reimbursement of maternity insurance benefits.

You should issue a certificate at your unit or neighborhood committee, and you can reimburse the maternity insurance at the hospital.

What expenses can be reimbursed by maternity insurance? Among the five insurances and one housing fund we participate in, one of the five insurances is maternity insurance, so maternity insurance, as the name suggests, is a reimbursement expense for giving birth to a child. In other words, female employees are there.

1. Required materials: the original and a copy of the "Marriage Certificate"; The original and a copy of the Maternity Service Certificate;

The original and a copy of the baby's birth certificate; Original and a copy of the medical diagnosis certificate; The "Beijing Maternity Allowance Applicant Information Registration Form" in duplicate (must be filled in with a black signature pen).

3. Handling process: The person in charge of the unit shall report to the social security center with the above materials, and pay the maternity allowance within 30 working days after acceptance and approval.

If the husband and wife meet the conditions for enjoying the incentive allowance for late childbirth (at least 23 years old), the husband and wife shall select the object of the late childbirth allowance in the "Beijing Information Registration Form for Persons Applying for Maternity Allowance", and the husband and wife shall sign and confirm it, and the units of both parties shall seal it.

If both husband and wife have participated in maternity insurance, the woman's unit shall fill in the "Beijing Municipal Information Registration Form for Persons Applying for Maternity Allowance"; If the woman has not participated in maternity insurance, but the man has participated in maternity insurance and the man is entitled to late childbirth allowance, the man's unit must fill in the "Beijing Maternity Allowance Applicant Information Registration Form" (in duplicate) and declare it.

1. Conditions for reimbursement of maternity insurance.

1) If an employee who has participated in maternity insurance for one year gives birth, he or she shall submit application materials for reimbursement of maternity medical expenses within one year after childbirth and within one year after family planning surgery;

2) If an employee who has participated in maternity insurance for less than 1 year gives birth, he or she shall submit application materials for reimbursement of maternity medical expenses within 1 year after he or she has participated in maternity insurance for 12 months;

3) If an employee who has participated in maternity insurance for one year or more gives birth to his or her unemployed spouse, the employee shall submit application materials within one year after the birth of his unemployed spouse and within one year after the family planning operation to go through the procedures for reimbursement of maternity medical expenses of his unemployed spouse;

4) If an employee who has participated in maternity insurance for less than one year and his or her unemployed spouse gives birth, the employee shall submit application materials within one year after the employee has participated in maternity insurance for 12 months to go through the procedures for reimbursement of maternity medical expenses for his unemployed spouse;

2. Coverage of maternity insurance.

1. Maternity medical expenses. The examination fees, midwifery fees, surgery fees, hospitalization fees and medicine expenses for female employees who give birth are paid by maternity insurance**. The medical business expenses and drug expenses (including the drug expenses for self-financed drugs and nutritional drugs) in excess of the prescribed regulations shall be borne by the employees themselves.

After a female employee is discharged from the hospital after giving birth, the medical expenses for diseases caused by childbirth shall be paid by maternity insurance**; Medical expenses for other diseases shall be handled in accordance with the provisions of medical insurance benefits. After the expiration of maternity leave, if a female employee needs to rest due to illness, it shall be handled in accordance with the provisions on sick leave and medical insurance benefits.

2. Maternity allowance. Female employees are entitled to maternity allowance during maternity leave in accordance with the law, which is calculated and paid according to the average monthly salary of employees in the previous year of the enterprise, and is paid by maternity insurance.

The reimbursement process for maternity examination expenses of maternity and fiber insurance is as follows: 1. Confirm that you meet the conditions for maternity reimbursement; 2. Prepare social security cards, baby birth certificates, maternity service contact sheets, hospitalization summaries, expense lists and invoices to the birth and birth insurance agency of the place where the insurance is insured to go through the reimbursement procedures. Article 55 of the Social Insurance Law includes the following items for maternity medical expenses:

1) Medical expenses for childbirth; (2) Medical expenses for family planning; (3) Other project expenses provided for by laws and regulations. Article 56 of the "Social Insurance Law" Employees who have any of the following circumstances may enjoy maternity allowance in accordance with the provisions of the State: (1) Female employees are entitled to maternity leave for childbirth; (2) Enjoy leave for family planning surgery; (3) Other circumstances provided for by laws and regulations.

The maternity allowance shall be calculated and paid according to the average monthly salary of the employee in the previous year.

The reimbursement process of maternity insurance refers to the procedure for the employer and the employee to reimburse the maternity medical expenses, maternity allowance and other expenses of the female employee during the childbirth period, and the nursing leave and leave allowance of the male employee during the childbirth period to the overall regional maternity insurance.

Application materials to be submitted by the employer:

1. Social insurance registration form;

2. The increase and decrease table of personnel participating in basic old-age, work-related injury and maternity insurance;

3. Summary table of basic pension, work-related injury and maternity insurance declaration for enterprise employees.

Application materials to be submitted by female employees who give birth:

1. Family planning certificate issued by the family planning department (original and photocopy);

2. Birth (death) certificate of the baby issued by the medical department (original and photocopy);

3. ID card of female employees who give birth and employees of family planning surgery (original and photocopy);

4. Examination and collection form of maternity medical certificate for enterprise employees;

5. Application form for medical certificate of family planning surgery for employees of enterprises;

6. Application form for reimbursement of maternity medical expenses for enterprise employees;

7. Approval and settlement of maternity insurance benefits for enterprise employees;

8. Application form for foreign medical treatment of maternity insurance for enterprise employees;

9. Original materials such as maternity medical expense bills, expense lists, outpatient medical records, and discharge summaries;

10. Receipt of payment.

As far as I know, the cost of examination or hospitalization caused by childbirth can generally only be solved through maternity insurance, and neither social insurance nor commercial insurance medical products can reimburse this expense. However, there are exceptions, that is, the employer has purchased some additional group supplementary medical insurance for you, if the agreement stipulates that the employee's maternity expenses can be reimbursed, but this is rare - you need to ask your company's personnel. You don't need to give them all the bills for maternity insurance reimbursement, enough 1100 is enough, but you should pay attention to the self-paid items to avoid not being enough.

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As long as the cumulative payment is met for 12 months; If the conditions are met, it can be used, the original and copy of the medical charge bill (invoice), and the original and copy of the corresponding expense summary list, and the original and copy of the discharge summary (discharge record); Medical insurance card: You can settle the outpatient treatment with the medical insurance card.

How should maternity insurance be reimbursed?

In social insurance, medical insurance and maternity insurance both belong to social insurance, and social insurance includes: endowment insurance, medical insurance, maternity insurance, work-related injury insurance, and unemployment insurance.

Social medical insurance is to pay part of yourself, pay part of the unit, your own part will be put into the medical insurance card, used to buy medicine, the part of the unit will be added to the social security ** co-ordination, for us to give a certain percentage of reimbursement when we are sick.

There are two main types of maternity insurance benefits, one is maternity allowance, and the other is maternity medical treatment. The latter is that the medical expenses incurred by female employees during pregnancy, childbirth or termination of pregnancy are reimbursed by social security**; The maternity allowance is calculated and paid according to the average monthly salary of the employees in the previous year and paid by the maternity insurance.

In commercial insurance, medical insurance and maternity insurance are two separate types of insurance, which can be purchased according to your needs.

The reimbursement principle of medical insurance in commercial insurance is similar to that of social medical insurance, which is generally used as a supplement to social medical insurance.

Maternity insurance in commercial insurance has restrictions, generally purchased before 28 weeks of pregnancy, insurance liabilities include: pregnancy and childbirth death, total disability, pregnancy disease, miscarriage, neonatal congenital malformations and neonatal death. In the event of an insured event, compensation will be made according to the amount of insurance purchased.

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